Association of the IgG response to Plasmodium falciparum merozoite protein (C-terminal 19 kD) with clinical immunity to malaria in the Brazilian Amazon region

The antibody response to the C-terminal 19-kD fragment of Plasmodium falciparum merozoite surface protein-1 (PfMSP1-19) was investigated in groups of subjects living in areas of Brazil with different levels of malaria transmission. The prevalence and the levels of IgG to PfMSP1-19 increased with the time of exposure and were positively correlated with the absence of clinical symptoms in parasitemic patients. The frequency of positive response and the mean level of IgG were higher in areas where malaria prevalence was more intense, especially among asymptomatic patients. The serum absorbance values of the IgG1 isotype were significantly higher among subjects with long-term exposure and in asymptomatic infections. These data suggest a protective role of IgG1 in naturally acquired immunity in spite of the unstable transmission levels in the Brazilian Amazon.     

Glycoconjugates of Trypanosoma cruzi: A 74 kD antigen of trypomastigotes specifically reacts with lytic anti-α-galactosyl antibodies from patients with chronic Chagas disease

Protective, lytic antibodies are believed to be correlated with active Typanosoma cruzi infection. In patients with chronic infection, antibodies lysing trypomastigote forms recognize chiefly α-galactosyl structures at the parasite surface. The target molecules on cell-derived trypomastigotes that react with anti-α-galactosyl antibodies (anti-Gal) from patients with chronic Chagas disease were investigated. Glycoconjugates were isolated from trypomastigotes and shown to absorb purified Chagasic (Ch) anti-Gal effectively as well as lytic antibodies from Ch sera. Active fractions were F2 (74 kD and 95.6 kD) and F3 (120–200 kD). A differential reactivity with antibodies from untreated Ch patients (trypanolytic) and from treated, presumably cured, individuals (not trypanolytic) was evident using F2 and F3 antigenic fractions. No cross-reactivity with heterologous sera (other infections) was observed. The F2 glycoconjugate (mostly 74 kD) can be used in the diagnosis of active Chagas infection, replacing the quantitative determination of complementmediated lysis. With the present sample of patients' sera and normal human sera, it showed 100% sensitivity and specificity. © 1993 Wiley-Liss, Inc.     

Regional cerebral blood flow (rCBF) in migraine during the interictal period: different rCBF patterns in patients with and without aura

The aim of this study was to evaluate the rCBF (¹³³Xe clearance method) in migrainous patients free from attack. Fifty patients suffering from migraine without aura (group M) and 20 suffering from migraine with aura (group MA) (age range 20-50 years) were submitted to 32 channel rCBF mapping during the interictal period. The rCBF data of patients were compared with those obtained from 60 healthy control subjects (group C) and 21 patients suffering from tension-type headache (group TH). The mean (average of all channels) rCBF values were: group M=70.5 ± 13.7ml/100g/min; group MA=56.6 ± 11.4ml/100g/min; group C=62.3 ± 8.3ml/100g/min; group TH=62.1 ± 8.4ml/100g/min (F=11.93; p <0.001). As expected, patients belonging to group TH had a normal rCBF. The mean rCBF of group M was significantly higher than that of groups C and TH, while in group MA it was significantly lower than in groups C and TH. Group M showed a diffuse hyperemia, while group MA showed rCBF values significantly lower than normal in posterior regions, according to aura. Our results suggest that: (a) the rCBF pattern in migrainous patients is different from that in both controls and TH patients, even during the interictal period; (b) patients suffering from migraine with and without aura are two distinct subpopulations with opposite rCBF deviations.     

Behavioural and emotional symptoms of preschool children with cerebral palsy: a population‐based study

Aim To describe behavioural and emotional symptoms among Icelandic preschool children with cerebral palsy (CP). Method Children with congenital CP, assessed with the Child Behavior Checklist/1½–5 (CBCL/1½–5) and Caregiver‐Teacher Report Form (C‐TRF), were enrolled in the study. A comparison group was recruited from the general population. Thirty‐six children (53% males) with CP were assessed at a mean age of 4 years 11 months (SD 5mo, range 4–6y); 26 (72%) had bilateral distribution of symptoms and 32 (89%) had spastic CP. Thirty (83%) were at Gross Motor Function Classification System levels I or II and six at levels III or IV. For comparison, 110 (43% males) and 120 (48% males) children were assessed with the CBCL/1½–5 and the C‐TRF respectively, at a mean age of 4 years 6 months (SD 6mo, range 4–6y). Results Sixteen children (48%) with CP had high scores on total problems scale of the CBCL/1½–5 and 20 (65%) on the C‐TRF compared with 18% of the comparison group, both on the CBCL/1½–5 and the C‐TRF (p<0.001). Children with CP had higher scores on all subscales of the CBCL/1½–5 and the C‐TRF, except somatic complaints. Attention difficulties, withdrawn, aggressive behaviour, and anxious/depressed symptoms were most pronounced among children with CP. Interpretation A large proportion of preschool children with CP have substantial behavioural and emotional difficulties, which need to be addressed in their treatment.     

The antiemetic efficacy of tropisetron plus dexamethasone as compared with conventional metoclopramide-dexamethasone combination in Orientals receiving cisplatin chemotherapy: a randomized crossover trial

1We report a single-blind randomized crossover trial comparing the efficacy of tropisetron plus dexamethasone (TROPDEX) vs conventional combination of metoclopramide, dexamethasone and diphenhydramine (METDEX) in prevention of acute and delayed vomiting in Chinese patients receiving high dose cisplatin. 2Thirty-six consecutive patients with nasopharyngeal carcinoma were entered into the study, all received cisplatin at a dose range of 60–100 mg/m². Patients were randomized in the sequence of antiemetic regimens used in two consecutive cycles. 3The TROPDEX regimen consisting of tropisetron 5 mg i.v. and dexamethasone 20 mg i.v. given on day 1 of chemotherapy, followed by oral maintenance with tropisetron 5 mg daily and dexamethasone 4 mg twice daily from day 2 to 6. The METDEX regimen consisting of metoclopramide 1 mg kg⁻¹ i.v., dexamethasone 20 mg i.v. and diphenhydramine 25 mg i.v. given before chemotherapy and then 2 hourly for two more doses on day 1, followed by oral metoclopramide 20 mg 6 hourly from day 2 to 6. 4Complete control of acute vomiting was observed in 64% of patients with TROPDEX as compared with 14% with METDEX (P<0.01). While complete plus major control of acute vomiting was observed in 84% with TROPDEX as compared with 58% with METDEX. The mean vomiting episodes on day 1 were 1.4 with TROPDEX as compared with 3.5 with METDEX (P<0.01). There was, however, no significant difference between the two regimens in the control of delayed vomiting. 5When patients randomized to TROPDEX in the second cycle were compared with those with TROPDEX in the first cycle, the antiemetic efficacy was reduced, with mean acute vomiting episodes of 2 in the former compared with 0.8 in the latter (P<0.01). 6The most common adverse effect observed was headache in TROPDEX (27%) and dizziness in METDEX (40%). 7In conclusion, the antiemetic regimen TROPDEX is effective in Chinese patients receiving high dose cisplatin chemotherapy and is well tolerated. It is better than conventional METDEX regimen in the control of acute vomiting, but not in the control of delayed vomiting.     

昆明市一所大学预防药物滥用及HIV／AIDS研究

在云南省财贸学院开展为期半年的预防药物滥用及感染性免疫缺陷病毒／艾滋病（ＨＩＶ／ＡＩＤＳ）活动。５３名自愿参加预防活动的大学生作为预防对象。预防方法以个人和社会技能训练为主，辅予信息传播方法和拒绝技能训练。训练课程分为８次，每次９０分钟。活动前后进行自身对照比较。结果显示，预防活动能提高预防对象相关知识的水平。预防对象的个人和社会技能比参加活动前有显著的提高。不足的是这种预防活动没有能改变预防对象对药物滥用及ＨＩＶ／ＡＩＤＳ的负性态度。研究对今后以学校为基础的预防方法提出了建议。     

Structure and expression of the gene for Pv200, a major blood-stage surface antigen of Plasmodium vivax

Molecular cloning and structure analysis of the gene encoding the Pv200 protein of the Sal-1 strain of Plasmodium vivax revealed an overall identity of 34–37% when the deduced amino acid sequence was compared with the sequences of various major merozoite surface antigens of Plasmodium falciparum, Plasmodium yoelii and Plasmodium chabaudi. When the Sal-1 Pv200 sequence was compared with the corresponding sequence from the Belèm strain of P. vivax, it was found that the two merozoite surface antigens were relatively well conserved with an overall amino acid sequence identity of 81%. A region of 23 repeated glutamine residues, found in the sequence of the Belèm isolate was not found, however, in the Sal-1 sequence. Amino-and carboxy-terminal domains of the Pv200 protein were expressed in the yeast Saccharomyces cerevisiae. Each recombinant protein was shown to react with antibodies in sera from splenectomized Bolivian Saimiri monkeys that had been infected previously with P. vivax, and in human sera from individuals with a history of exposure to vivax malaria. The availability of recombinant DNA-derived Pv200 proteins will now allow a full assessment of their utility in the diagnosis and immunoprophylaxis of the benign tertian malaria associated with P. vivax infection.     

Humoral immune response to the Trypanosoma cruzi complement regulatory protein as an indicator of parasitologic clearance in human Chagas' disease.

Immunoprecipitation of the purified 160-kDa complement regulatory protein of Trypanosoma cruzi by Chagas' disease patient sera was examined as a possible correlate of the complement-mediated lysis test and as an indicator of parasite clearance. The results presented demonstrate that assessment of the humoral response to this antigen is a useful indicator of parasite clearance and may be particularly helpful in the assessment of some patients for whom other serological tests produce ambiguous results.